摘要
目的 通过分析青少年重症肌无力（JMG）患者骨龄和身高的发育情况来探讨胸腺手术对JMG患者生长发育的影响.方法 采用横断面研究方法,依次纳入2011年7月至2014年8月就诊于中山大学附属第一医院神经科门诊的80例JMG患者,收集临床资料,根据身高标准差分值（Ht SDS）和骨龄的分布情况,明确JMG患者是否伴有身高和骨龄的发育异常,采用相关性分析和线性回归分析的统计方法探讨影响JMG患者身高和骨龄的因素.结果 （1）JMG患者骨龄与实际年龄（CA）比较延迟（0.15±1.32）岁,身高标准差分值均值为（-1.25±1.03）分;（2）多因素线性回归分析显示发病年龄进入以骨龄延迟为因变量的回归方程（P =0.007）,激素累积使用量进入以Ht CASDS为因变量的回归方程（P=0.043）;（3）胸腺手术组患者身高和骨龄的分布与非手术组比较差异无统计学意义（P＞0.1）.结论 （1）JMG患儿存在骨龄延迟和身高发育低于同龄正常水平;（2）发病年龄是骨龄延迟的影响因素,激素累积用量是身高发育受限的影响因素;（3）胸腺手术对MG患儿的骨龄和身高发育无明显影响.
Objective To explore the effects of clinical indicators,particularly thymectomy on the development of juvenile myasthenia gravis （JMG） through the developmental status of bone age （BA） and height.Methods A cross-sectional study of 80 JMG patients was recruited to examine whether JMG patients had the abnormalities of height and bone development according to the distribution of height standard deviation score （Ht SDS） and BA.Results The mean BA was delayed by （0.15 ± 1.32） years compared with patient chronological age （CA）.The mean Ht SDS （HtCA SDS-1.25 ± 1.03） was also lower than healthy controls.In multivariate analysis,the age at onset was negatively associated with delayed BA （P =0.007） whereas the cumulative intake of prednisone was negatively associated with HtCASDS （P =0.043）.No significant correlation existed between thymectomy and delayed BA or HtCA SDS.Delayed BA and slow growth existed in JMG patients.The age at onset of JMG was a correlative factor for delayed BA.And the intake of cumulative prednisone might be a determinant of height retardation.Thymectomy had no impact on the development of bone and height.Conclusion We should pay more attention to monitoring BA and height in JMG patients to take appropriate therapeutic interventions.
出处
《中华医学杂志》
CAS
CSCD
北大核心
2015年第21期1671-1676,共6页
National Medical Journal of China
基金
国家自然科学基金（81371386）
中山大学临床研究5010计划（2010003）
